Tavlin Kaur

The applicant sought statutory accident benefits following a motor vehicle accident.

The insurer scheduled multiple insurer examinations to assess entitlement to attendant care benefits, non-earner benefits, and treatment plans.

The applicant failed to attend the examinations.

The insurer argued the applicant was barred from proceeding under section 55(1)2 of the Schedule.

The Tribunal found the insurer's notices of examination complied with section 44(5) of the Schedule and the applicant provided no reasonable explanation for her non-attendance.

The application was dismissed.

The applicant was involved in a motor vehicle accident in 2018 while a minor but did not notify the insurer of her intention to apply for statutory accident benefits until 2022.

The insurer denied benefits due to the delay.

The Licence Appeal Tribunal held that the Limitations Act did not apply to its proceedings and that section 7 of the Licence Appeal Tribunal Act did not apply to the notice requirement under section 32(1) of the Schedule.

Applying the Horvath factors, the Tribunal found the applicant's explanation for the delay was not credible or supported by evidence.

The application was dismissed.

The applicant was involved in a motor vehicle accident and sought statutory accident benefits.

She failed to notify the insurer of her intention to apply within the required seven-day period.

The insurer denied benefits and the matter proceeded to a preliminary issue hearing.

The applicant argued her delay was due to mental health issues, including anxiety and procrastination.

The Tribunal found the applicant's explanation was not credible or supported by medical evidence, noting she was able to seek treatment and work during the delay period.

The application was dismissed as the applicant was barred from proceeding.

The applicant sought statutory accident benefits following a motor vehicle accident.

The respondent insurer scheduled multiple insurer's examinations (IEs) which the applicant allegedly failed to attend, and the respondent argued the applicant was therefore barred from proceeding under section 55 of the Schedule.

The Tribunal found that the respondent's notices of examination failed to comply with the strict requirements of section 44(5) because they did not provide sufficient medical reasons or specific details about the applicant's condition.

Consequently, the applicant was not barred from proceeding with the application.

The applicant sought statutory accident benefits following a motor vehicle accident and disputed the insurer's denial of two treatment plans for chiropractic services.

The insurer raised a preliminary issue, arguing the application was statute-barred because it was filed beyond the two-year limitation period under section 56 of the Schedule.

The Tribunal found that the insurer's denial notices were defective as they relied on boilerplate language and failed to provide clear medical reasons for the denials, contrary to the requirements in Smith v. Co-operators.

Consequently, the defective notices did not trigger the limitation period, and the applicant was permitted to proceed with the application.

The applicant sought statutory accident benefits following a 2014 motor vehicle accident involving his children.

In 2021, he submitted treatment plans for psychological injuries, which the insurer denied because he had not submitted an Application for Accident Benefits (OCF-1) or provided a reasonable excuse for the delay.

The Tribunal found that the applicant failed to notify the insurer of his intention to apply for benefits within seven days or as soon as practicable, as required by section 32(1) of the Schedule.

The applicant provided no reasonable explanation for the multi-year delay.

Consequently, the application was dismissed.

The applicant was injured in a motor vehicle accident and sought funding for a driving reintegration assessment.

The respondent insurer denied the treatment plan and scheduled an insurer's examination (IE), which the applicant failed to attend.

The respondent argued the applicant was barred from proceeding to a hearing under s. 55(1)2 of the Schedule.

The Tribunal found that the respondent's notice of examination was defective as it failed to provide specific medical reasons for the examination, relying instead on boilerplate language that did not address the applicant's actual condition or the benefit in dispute.

Because the notice did not comply with s. 44(5) of the Schedule, the respondent could not rely on the applicant's non-attendance to bar the application.

The applicant was permitted to proceed to a hearing.

The respondent requested a reconsideration of a preliminary issue decision which found she was not involved in an 'accident' when she slipped and fell on ice after exiting a vehicle.

She alleged errors of law and fact, including the Tribunal's failure to consider section 32 of the Schedule, its reliance on binding Divisional Court case law over non-binding Tribunal decisions, and a perceived conflict of interest based on an allegation that the adjudicator and her counsel attended the same law school.

The Tribunal dismissed the request, finding no errors of law or fact, and noting that the bias allegation was factually inaccurate and insufficient to overcome the presumption of impartiality.

The applicant sought statutory accident benefits following a motor vehicle accident.

The insurer denied several treatment plans and scheduled insurer's examinations (IEs), which the applicant failed to attend.

The insurer argued the applicant was barred from proceeding to a hearing under section 55 of the Schedule.

The Tribunal found that the insurer's notices of examination were deficient because they relied on boilerplate language and failed to provide specific medical reasons or refer to the applicant's medical conditions, contrary to section 44(5) of the Schedule.

Consequently, the applicant was not barred from proceeding with his application.

The applicant sought statutory accident benefits following a motor vehicle accident.

The respondent insurer denied benefits and argued as a preliminary issue that the applicant was barred from proceeding to a hearing under s. 55 of the Schedule for failing to attend an insurer's examination.

The Tribunal found that the respondent failed to provide copies of the notices of examination relevant to the issues in dispute, and therefore could not prove the notices complied with the strict requirements of s. 44(5).

The applicant was permitted to proceed to a substantive hearing.

The applicant sought statutory accident benefits following a motor vehicle accident.

The insurer denied income replacement benefits, arguing the applicant's policy was cancelled for non-payment and he failed to submit a disability certificate (OCF-3).

The Licence Appeal Tribunal found the insurer did not prove the applicant knew or ought reasonably to have known his vehicle was uninsured at the time of the accident.

However, the Tribunal held the applicant was not entitled to income replacement benefits for any period prior to submitting a completed OCF-3, as he failed to provide a reasonable explanation for the delay.

The Tribunal also ruled it lacked jurisdiction to grant relief from forfeiture.

The applicant sought statutory accident benefits following a 2000 motor vehicle accident.

The parties engaged in mediation and arbitration at FSCO, ultimately reaching a settlement in 2004.

The applicant signed the Settlement Disclosure Notice (SDN) by initialing each page but did not sign the specific acknowledgment line.

Years later, the applicant attempted to reopen the claim, arguing the settlement was invalid due to the missing signature.

The Tribunal found that a binding contract existed, the SDN substantially complied with O. Reg. 664, and the applicant failed to rescind the settlement within the two-business-day cooling-off period.

The application was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident.

The respondent denied several benefits and requested the applicant attend insurer's examinations under section 44 of the Schedule.

The applicant failed to attend the scheduled examinations without providing a reasonable explanation.

The Tribunal found that the notices of examination complied with the Schedule's requirements.

Consequently, the applicant was barred under section 55 from proceeding with her claims for the income replacement benefit and two treatment plans, but was permitted to proceed with a third treatment plan for which no examination had been scheduled.

The applicant requested a reconsideration of a preliminary issue decision which found she was not involved in an accident.

The applicant argued the Tribunal erred in law and fact by finding her leg collapsing was an intervening cause and by misapplying the dominant feature test.

The Tribunal dismissed the request, finding the applicant was attempting to re-argue her case and had not established any error of law or fact under Rule 18.2.

The applicant sought medical and rehabilitation benefits following a motor vehicle accident.

The respondent denied the treatment plans on the basis that they were submitted more than 260 weeks after the accident, contrary to section 20(1)(a) of the Statutory Accident Benefits Schedule.

The applicant failed to file submissions or evidence demonstrating that the expenses were incurred prior to the deadline or that any exceptions applied.

The Licence Appeal Tribunal found the claims were time-barred and dismissed the application.

The applicant sought income replacement benefits (IRB) following a 2016 motor vehicle accident.

The insurer denied the IRB in June 2016, and the applicant returned to work.

In 2022, the applicant went on medical leave and submitted an updated disability certificate, which the insurer denied based on the 2016 denial.

The Tribunal found the applicant failed to dispute the denial within the two-year limitation period under section 56 of the Schedule.

Applying the Manuel factors under section 7 of the LAT Act, the Tribunal declined to extend the limitation period, finding no bona fide intention to appeal, significant unexplained delay, prejudice to the insurer, and lack of merit.

The applicant was injured in a motor vehicle accident while driving a transport truck for work.

He initially applied for and received benefits from the Workers' Compensation Board-Alberta (WCB), but later attempted to withdraw his claim to pursue statutory accident benefits from the respondent insurer.

The WCB refused to withdraw the claim and suspended benefits due to the applicant's failure to participate in treatment.

The Tribunal held that under section 61 of the Schedule, the respondent insurer is not required to pay accident benefits because the applicant continues to be entitled to claim workers' compensation benefits under the WCB.

The application was dismissed.

The applicant sought accident benefits for psychological injuries sustained after witnessing his mother fall from her wheelchair while being loaded into a taxi, which ultimately resulted in her death.

Neither the applicant nor his mother had automobile insurance, so the applicant sought benefits from the taxi company's insurer.

The Tribunal held that the applicant did not meet the definition of an 'insured person' under section 3(1)(a)(ii) of the Statutory Accident Benefits Schedule because neither he nor his mother were named insureds or dependants of a named insured under the policy.

The application was dismissed.

The applicant was involved in a motor vehicle accident on September 3, 2016, and sought statutory accident benefits.

The respondent denied treatment plans submitted in October 2021 and June 2022 on the basis that the applicant's injuries fell within the Minor Injury Guideline.

The respondent raised a preliminary issue that the application was time-barred under section 20 of the Statutory Accident Benefits Schedule, as the treatment plans were submitted more than 260 weeks (five years) after the accident.

The applicant did not file submissions or evidence.

The adjudicator found that the applicant was over 18 at the time of the accident, had not sustained a catastrophic impairment, and had not purchased optional benefits.

Therefore, the 260-week limit applied, and the application was dismissed as time-barred.

The applicant sought statutory accident benefits following a motor vehicle accident.

The respondent insurer denied benefits and raised a preliminary issue that the applicant was barred from proceeding with her application under section 55 of the Schedule for failing to attend insurer's examinations under section 44.

The Tribunal found that the respondent failed to submit the Notice of Examination into evidence, making it impossible to determine if the notice complied with the strict requirements of section 44(5).

As the respondent failed to discharge its burden of proof, the Tribunal held that the applicant was not barred from proceeding with her application.